INSTRUMENT ASSISTED ABDOMINAL ACCESS

• US 20070123840A1
• Filed: 10/18/2006
• Published: 05/31/2007
• Est. Priority Date: 10/18/2005
• Status: Abandoned Application

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: COX, John
• Application Number:
  US11/550,739
• Publication Number:
  US 20070123840A1
• Time in Patent Office: Days
• US Class Current: 604/514
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00619 Locking means for locking the implement in expanded state
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00672 Locating means therefor, e.g. bleed back lumen
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0443 the shaft being resilient and having a coiled or helical shape in the released state
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2090/3962 palpable
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Instrument assisted abdominal access methods and apparatus are described herein. A shape-lockable elongate body can be advanced endoluminally in a flexible state into the stomach, where an opening is created through the stomach wall. The opening can be created endoluminally or by incising instruments placed through the abdominal wall. The elongate body can be transitioned to a rigid state prior to, during, or after advancement into the patient and is passed through the opening into the peritoneal cavity. To assist in the passage of the elongate body, a helical tissue engager can be advanced into the peritoneal cavity and temporarily anchored into a tissue wall. By pulling the helical tissue engager proximally and pushing the elongate body over a flexible length of the engager, the elongate body can be brought into the peritoneal cavity

Claims

1. A method for endoluminally accessing a space within a patient body, comprising:

advancing an elongate body in a flexible state through a natural orifice into the patient body;

creating an opening through a tissue wall of a body lumen for accessing the space within the patient body;

advancing a tissue engagement device upon a flexible elongate member through the opening into the space;

anchoring the tissue engagement device into a tissue wall outside the opening; and

passing at least a distal portion of the elongate body over the flexible elongate member and through the opening.

2. The method of claim 1 further comprising transitioning the elongate body from the flexible state to a rigid state prior to anchoring the tissue engagement device.

3. The method of claim 2 further comprising transitioning the elongate body from the rigid state back to the flexible state prior to or while passing at least a distal portion of the elongate body.

4. The method of claim 1 wherein advancing an elongate body comprises passing the elongate body trans-esophageally into a stomach.

5. The method of claim 1 wherein creating an opening comprises piercing or ablating a hole through a stomach wall for accessing a peritoneal cavity within the patient body.

6. The method of claim 1 wherein creating an opening further comprises dilating the opening.

7. The method of claim 6 wherein dilating the opening comprises expanding the opening via a dilation balloon.

8. The method of claim 1 wherein creating an opening comprises creating the opening from an exterior surface of the tissue wall.

9. The method of claim 8 wherein creating the opening from an exterior surface comprises forming at least one incision in an abdominal wall of the patient body and passing an incising instrument through the at least one incision towards the exterior surface.

10. The method of claim 1 wherein advancing a tissue engagement device comprises advancing a rotatable corkscrew positioned upon the flexible elongate member.

11. The method of claim 10 wherein anchoring the tissue engagement device comprises torquing the corkscrew into the tissue wall.

12. The method of claim 1 wherein passing at least a distal portion comprises pulling the flexible elongate member proximally while pushing the elongate body distally over the flexible elongate member.

13. The method of claim 1 further comprising disengaging the tissue engagement device from the tissue wall.

14. A method for endoluminally accessing a body space, comprising:

advancing an elongate body in a flexible state through a natural orifice into the patient body;

creating an opening through a tissue wall of a body lumen for accessing the space within the patient body;

advancing a corkscrew anchor disposed upon a flexible elongate member through the opening into the space;

rotating the corkscrew anchor into a tissue wall outside the opening; and

passing at least a distal portion of the elongate body over the flexible elongate member and through the opening.

15. The method of claim 14 further comprising transitioning the elongate body from the flexible state to a rigid state prior to anchoring the corkscrew.

16. The method of claim 15 further comprising transitioning the elongate body from the rigid state back to the flexible state prior to or while passing at least a distal portion of the elongate body.

17. The method of claim 14 wherein advancing an elongate body comprises passing the elongate body trans-esophageally into a stomach.

18. The method of claim 14 wherein creating an opening comprises piercing or ablating a hole through a stomach wall for accessing a peritoneal cavity within the patient body.

19. The method of claim 14 wherein creating an opening further comprises dilating the opening.

20. The method of claim 19 wherein dilating the opening comprises expanding the opening via a dilation balloon.

21. The method of claim 14 wherein creating an opening comprises creating the opening from an exterior surface of the tissue wall.

22. The method of claim 21 wherein creating the opening from an exterior surface comprises forming at least one incision in an abdominal wall of the patient body and passing an incising instrument through the at least one incision towards the exterior surface.

23. The method of claim 14 wherein passing at least a distal portion comprises pulling the flexible elongate member proximally while pushing the elongate body distally over the flexible elongate member.

24. The method of claim 14 further comprising disengaging the corkscrew anchor from the tissue wall.